FLORIDA  EAST  COAST  POST-POLIO  SUPPORT  GROUP

12 Eclipse Trail  /  Ormond  Beach,  FL  32174  /  386  676-2435

E-Mail:-  bgold@iag.net   --   Web Site:-  home.iag.net/~bgold/polio.htm

 

MEETING CANCELLATION NOTICE

 

Due to unforeseen circumstances

The September 19th, 2004 support group meeting

is CANCELLED

 

Our next meeting will be on

November 21st, 2004

 

Unfortunately Barbara took a fall, breaking her left shoulder bone (her good arm) and is unable to function as she would like to. 

 

 

Our guest speaker, Dave Clark, will be rescheduled for

a meeting in 2005.

 

 

Our apologies for any inconvenience this

cancellation may cause.

 

Barbara

 
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FLORIDA  EAST  COAST  POST-POLIO  SUPPORT  GROUP   -   Vol. 12   #2

12 Eclipse Trail  /  Ormond  Beach,  FL  32174  /  386  676-2435

E-Mail:-  bgold@iag.net   --   Web Site:-  home.iag.net/~bgold/polio.htm

SEPTEMBER/OCTOBER   2004

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WISHING  ALL OUR FRIENDS

 

A   LABOR FREE LABOR DAY

A SHANA TOVAH (HAPPY NEW YEAR)

TO ALL OUR JEWISH MEMBERS AND FRIENDS

and  -

A CANDY FILLED  HALLOWEEN

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MEETING  NOTICE

 

 

MEETING CANCELLED

September 19th, 2004 -- Speaker:- Dave Clark a polio survivor who played minor league baseball while wearing braces on both legs and using crutches.  A motivational speaker worth listening to.

November 21st, 2004 --

January 16th,  2005 --  NEW  YEAR’S  LUNCHEON

 

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CONTENTS

 

From Barbara                                            1

New Slant on Salk                                     2

August is Cataract Awareness

                                                                   Month                                               2

Aging Gracefully                                       4

Diclofenac Sodium – Medical Alert         5

Too Many People Ignore Chronic Pain   6

Ain’t It Da’ Truth                                         8

Medicare                                                    8

Normalcy                                                   10

Swallowing and GERD                             11

S.O.S. Save Our Shoulders:

                                                                   A Guide for Polio Survivors            12

Diabetes and Post-Polio Syndrome        13

“I Wish for You”                                        14

Easy Tool to Evaluate for Stroke             15

Letter from Member                                  15

Nigeria restarts Polio Campaign              16    

 

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FROM BARBARA

Our September speaker, Dave Clark, is a unique person who serves as a shining example for others to follow.  Dave delivers a feel-good courageous story that will motivate you to fulfill your potential.

         

Dave talks about how he overcame polio as a young child to go on to have a successful career as a professional baseball player and manager – he has been a scout for the San Diego Padres since 1999.

 

          I heard Dave talk at a Post-Polio Conference last year and found it quite inspirational….  Well worth your coming to the meeting.

 

          See you at the Red Lobster……

 

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Dr. Mary Westbrook e-mailed us her Polio Particles 17 allowing us to use the following item in our newsletter.  Thank you Dr. Westbrook.

 

New slant on Salk

 

The world premiere of Undoing Salk, a play by Robert Benedetti, took place in Pittsburgh in February on the 50th anniversary of the Salk vaccine’s trials on 2 million American children. In an interview in Art and Entertainment (4/2/04) Benedetti explains that not everyone loved Salk. The play examines both sides of Salk’s controversial personality and the behind-the-scenes conspiracy within the medical community to squash the vaccine before it was released. Salk was the son of Russian-Jewish migrants, the first person in his family to attend college. As a medical researcher he, with his staff at Pittsburgh Medical School, devoted 8 years to developing a polio vaccine. Unlike other scientists, who were experimenting with vaccines using live virus, Salk used killed viruses. Many who worked with Salk came to resent what they perceived as his arrogance, professional distance, quickness to place blame, reluctance to share credit and tendency to disregard established medical practices. Salk refused to patent the vaccine. ‘On one level this is like the Galileo story,’ says Benedetti. ‘The science which Salk based his research on was viewed as heretical and he was viewed as a heretic by the American Medical Association and the Eisenhower administration, which saw [the lack of patenting] as socialized medicine’. The playwright says his play uncovers the undoing of Salk by a conspiracy between the profit seeking drug companies, the AMA, the government, jealous fellow scientists and Salk’s own hubris. Salk never received a Nobel Prize. After several years of interviewing people who knew Salk, Benedetti describes him as a flawed man with big dreams who continues to be hated by some and adored by others. The Salk vaccine was used for 6 years before being largely replaced by Sabin’s live vaccine. Western countries are now returning to the Salk vaccine as the safer option.

 

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Even though this is our September/October newsletter, felt the information in this article was important enough to

insert in our newsletter.

Reprinted from “Elder Update”, July/August 2004, Health and Wellness Column.   

 

August is

Cataract Awareness Month

Questions and Answers

About Cataracts

          A cataract is a clouding of the lens in the eye that effects vision.  Most cataracts are related to aging.  Cataracts are very common in older people.  By age 80, more than half of all Americans either have a cataract or have had cataract surgery.

          A cataract can occur in either or both eyes.  It cannot spread from one eye to the other.

 

How do cataracts develop?

          Age related cataracts develop in two ways:

1.  Clumps of protein reduce the sharpness of the image reaching the retina.

          The lens consists mostly of water and protein.  When the protein clumps up, it clouds the lens and reduces the light that reaches the retina.  The clouding may become severe enough to cause blurred vision.  Most age-related cataracts develop from protein clumpings.

          When a cataract is small, the cloudiness affects only a small part of the lens.  You may not notice any changes in your vision.  Cataracts tend to “grow” slowly, so vision gets worse gradually.  Over time, the cloudy area in the lens may get larger, and the cataract may increase in size.  Seeing may become more difficult.  Your vision may get duller or blurrier.

2.  The clear lens slowly changes to a yellowish/brownish color, adding a brownish tint to vision.

          As the clear lens slowly colors with age, your vision gradually may acquire a brownish shade.  At first, the amount of tinting may be small and may not cause a vision problem.  Over time, increased tinting may make it more difficult to read and perform other routine activities.  This gradual change in the amount of tinting does not affect the sharpness of the image transmitted to the retina.

          If you have advanced lens discoloration, you may not be able to identify blues and purples.  You may be wearing what you believe to be a pair of black socks, only to find out from friends that you are wearing purple socks.

 

Who is at risk for cataract?

          The risk of cataract increases as you get older.  Other risk factors for cataract include:

·        Certain diseases (for example, diabetes).

·        Personal behavior (smoking, alcohol use).

·        The environment (prolonged exposure to ultraviolet sunlight).

 

What are the symptoms of a cataract?

          The most common symptoms of a cataract are:

·        Cloudy or blurry vision.

·        Colors seem faded.

·        Glare.  Headlights, lamps or sunlight may appear too bright.  A halo may appear around lights.

·        Poor night vision.

·        Double vision or multiple images in one eye.  (This symptom may clear as the cataract gets larger.)

·        Frequent prescription changes in your eyeglasses or contact lenses.

 

These symptoms also can be a sign of other eye problems.  If you have any of these symptoms, check with your eye care professional.

 

How is a cataract detected?

          Cataract is detected through a com-prehensive eye exam that includes:

·        Visual acuity test.  This eye chart test measures how well you see at various distances.

·        Dilated eye exam.  Drops are placed in your eyes to widen, or dilate, the pupils.  Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems.  After the exam, your close-up vision may remain blurred for several hours.

·        Tonometry.  An instrument measures the pressure inside the eye.  Numbing drops may be applied to your eye for this test.

 

Your eye care professional also may do other tests to learn more about the structure and health of your eye.

 

How is a cataract treated?

          The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses.  If these measures do not help, surgery is the only effective treatment.   Surgery involves removing the cloudy lens and replacing it with an artificial lens.

          A cataract needs to be removed only when vision loss interferes with your everyday activities, such as driving, reading or watching TV.  You and your eye care professional can make this decision together.  Once you understand the benefits and risks of surgery, you can make an informed decision about whether cataract surgery is right for you.  In most cases, delaying cataract surgery will not cause long-term damage to your eye or make the surgery more difficult.  You do not have to rush into surgery.

          Sometimes a cataract should be removed even if it does not cause problems with your vision.  For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy.

          If you choose surgery, your eye care professional may refer you to a specialist to remove the cataract.

          If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually four to eight weeks apart.

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More than half of all Americans develop cataracts by age 80.  Although 20.5 million Americans age 40 and older have cataracts, cataracts are one of the most curable causes of vision loss.

Source:  The American Academy of Ophthalmology (www.aao.org)                         

======================================================================

Source:  The National Eye Institute (NEI), which conducts and supports research that leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness.  The NEI is part of the National Institutes of Health (NIH), an agency of the U.S. Department of Health and Human Services (http://www.net.nei.

nih.gov/health/cataract/cataract_facts.htm #1).

 

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Reprinted from PPSG Chronicles, Bethlehem, PA, Volume 11, No. 2, June 2004

 

AGING GRACEFULLY

         

“Aging Gracefully May be Life Extending,” ran a Reuters headline in July 2002, referring to results of a research study.  But can the concepts of “aging” and “grace” really be combined?  They can be indeed!

 

          With age comes the benefits of wisdom and clear perspective.  These gifts, if appreciated, can contribute much to family and community.  Yet, aging “gracefully” is not always easy.  Even while acknowledging that they have arrived at a stage in life when chronic disorders may multiply and health is more fragile, older adults must learn to discard the negative stereotypes of old age and relearn what it means to age in America.  No one doubts that this may require deep resources of courage and patience.

 

          However, many of America’s mature citizens already have discovered strategies for graceful aging.  Foremost is the old favorite:  “positive thinking.”

 

          Researchers have noticed that individuals with strong spirituality tend to live longer as well as have healthier habits and better overall health.  The particular study that inspired the Reuters headline quoted above was led by Dr. Becca R. Levy of Yale University.  It focused on 660 adults ages 50 and older from an Ohio town.  In 1975, participants were asked to respond to various statements such as, “As you get older, you are less useful” and “Things keep getting worse as I get older.”  Then, 23 years later, their attitudes (based on those same questions) were compared with their longevity.  Dr. Levy and her team found that the adults who showed positive self-perceptions toward aging had a distinct survival advantage, living an average of 7.5 years longer than others.  Their longer survival did not seem to depend on any other factor (age, sex, socioeconomic status, loneliness, or health).

 

          This study seems to confirm the link between health and attitude, body and mind – a link that today has become accepted in many medical school curricula.

 

          One of the most inspiring examples of positive mind/body self-healing is that of Norman Cousins, editor of the Saturday Review of Literature, who showed that taking charge and using humor as medicine could actually conquer disease.  He was way ahead of the medical schools, which were at a loss in finding the connection between the body and mind in the healing process.  But in 1964, he was diagnosed with anklylosing spondylitis, a highly painful, crippling condition that causes disintegration of spinal connective tissue.  He wrote in his book, Anatomy of an Illness, that he became aware that hospital life was depressing him.  So he checked himself out, moved into a hotel where the food was decent and watched funny movies.  He hired a nurse who read him humorous stories.  He discovered that laughter has the power to conquer pain; 15 minutes of laughter could guarantee him 2 hours of pain-free sleep.  He also followed a regimen of high-dose vitamin C.  Finally to the amazement of his doctors, Cousins reversed a supposedly irreversible disease.  “I have learned,” he wrote, “never to underestimate the capacity of the human mind and body to regenerate – even when the prospects seem most wretched.”

 

          Despite the changes that growing older entails, staying as active and involved as possible are key to staying positive and maintaining your health.  The end result is a rewarding life in harmony with others, in short, aging gracefully.

From Polio Connection of America, January 2004

 

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Reprinted from Post-Polio Awareness and Support Society of British Columbia (PPASS NEWS), July/August 2004

 

Diclofenac Sodium –

Medical Alert

                                                                                                                                    By Jennie Bedford

 

          A couple of our members have experienced very nasty side effects – a stomach ulcer and an eye ulcer – from the use of diclofenac sodium, and have asked me to pass on this alert.

 

          Diclofenac sodium is sold as both an oral Non-Steroidal Anti-Inflammatory (NSAID) medication: (VColtaren tablets, Cataflam tablets, Voltaren-XR tablets) and eye drops (Voltaren Ophtha).

 

          A reminder to all of you (PPSers and others):  Ensure that you know the side effects of all of your medications.  It’s your body, not your doctor’s!  Discuss medications with your doctor and/.or pharmacist before you fill your prescriptions.  READ the full write-up on your prop0osed medication – both your doctor and your pharmacist have a huge “tome” containing full details of all medications.  Please don’t be afraid to ask your doctor and/or pharmacist questions.

For more information on Diclofenac Sodium Warnings/Precautions see:

  www. rxlist.com/cgi/generic/diclofen_wcp.htm

For more information on Diclofenac Sodium Side Effects see:  www.rxlist.com/generic/diclofen_ad.htm

FECPPSG Editor’s Note:-  I checked this out with a pharmacist friend of mine who’s only comment was that she wasn’t sure that the eye drops were being used in the states at this time.  But that it is a good article.  She also said that too many people take their medications without asking what they are for and/or if there are any side effects.  Please be sure to check with your doctor – or – your pharmacist to make sure you won’t have any problems.

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Reprinted from Polio Epic, AZ – with thanks for e-mailing the article over to us thereby lessening the hours of typing Barbara has to do.

 

Too Many People Ignore Chronic Pain
Pain Medication, Physical Therapy, Better Coping Skills All Help Ease Pain

By Jeanie Lerche Davis

 

 



May 6, 2004 -- The majority of chronic pain sufferers put off seeing a doctor. Many are in denial about their constant pain. They shrink their lives to fit their condition, a new survey shows.

 

The nationwide random survey, released today by the American Chronic Pain Association, provides a snapshot of how chronic pain affects quality of life. The survey results are based on telephone interviews with 800 people who have chronic pain.

 

Pain Sets In Early for Some

Anyone can develop chronic pain -- but it commonly occurs in older adults or others with health conditions, such as diabetes, arthritis, or back problems. However, persistent pain is not a normal part of aging. And even people in their 20s and 30s develop chronic pain.

 

Treatment typically involves prescription painkillers or other medication, physical therapy, exercise, and therapy to develop better coping skills. Alternative treatments -- like acupuncture and yoga -- can also help. While chronic pain cannot be cured, it can be managed well enough to significantly improve the quality of your life.  "Pain really can affect your quality of life -- emotionally, physically, how we deal with stress, how active we are, says Penney Cowan, executive director of the American Chronic Pain Association.” And, unfortunately, many people don't get treatment until they are practically nonfunctional."  At age 25, Cowan felt the first symptoms of fibromyalgia -- chronic, widespread muscle pain -- and ignored it for two years until it nearly incapacitated her.   In fact, chronic pain often begins much earlier than most people realize. And among people between ages 18 and 34 with chronic pain, 82% of them are affected emotionally by their chronic pain, the survey showed.   "We're seeing a lot of younger people experiencing pain, more than you would expect," Cowan tells WebMD. "I think it's the more active lifestyle we're leading, a lot more sports-related injuries. We need to educate people on preventing pain and on getting adequate treatment immediately to hopefully avoid long-term pain."

 

Quality of Life Seriously Affected

Careers and personal lives are affected by the pain, says Cowan. "Employers, people in general don't realize how debilitating it can be. Pain is invisible. People can't see that anything hurts. If they see you acting OK, they think you're good to go for everything. That might not be true."

 

Among the survey results:

·        Women are more likely to be

affected emotionally by their pain than men.

·        70% of pain sufferers feel greater

stress and 55% feel less motivation as a result of their pain.

·        Nearly three in 10 men have flagging

libido due to chronic pain.

·        41% of workers with chronic pain say

their pain adversely affects their ability to put in a full day's work.

·        Three in 10 say it affects their ability

to get to work.

·        One in six employed people living

with chronic pain say it has adversely affected their career advancement opportunities.

 

Treatment Works

Treatment does offer relief, says Cowan. "We have to learn to live with the pain, manage it, apply better coping skills, pace ourselves, and know our abilities. The big message is, realize that there are things you may not be able to do. But don't dwell on that, focus on what you can do."

Her survey showed the positive effects of getting treatment:

·        81% of people seeing a doctor for

pain report being very satisfied.

·        86% of people taking prescription

pain medication are also using altern-atives, like physical therapy, massage, and meditation.

However:

·        56% of those taking pain medica-

tions worry about side effects.

·        52% report drowsiness and 41% say

they have had nausea from pain medi-cations.

 

"Pain is not simple," says Cowan. "Finding the right doctor can be difficult. Doctors and nurses are not really trained in pain management. They're trained in diagnosis and treatment of disease, but not in managing pain. And because it's complex, treating pain takes a team approach, with the patient playing an active role."

 

Start with your primary care doctor, she advises. "You have to start at the beginning, rule out certain causes. You may have to see a few specialists. Even then, there aren't always clear answers."   The bottom line: If you have pain, taking an active role will help bring relief, Cowan says. "When you do that, you can start living again."

SOURCES: Penney Cowan, executive director, American Chronic Pain Association. American Chronic Pain Association. WebMD Medical Reference from Healthwise: "Chronic Pain."

 

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This little piece was sent to me by one of my friends at HAVOC (Handicapped Adults of Volusia County) –

Thanks, Paul. ------- Had to put it in as it rings so true……

 

AIN’T IT DA’ TRUTH!!

 

Thought I’d let my doctor check me

cause I didn’t feel quite right.

All those aches and pains annoyed me

And I couldn’t sleep at night.

 

He could find no real disorder

But he wouldn’t let it rest.

What with Medicare and Blue Cross,

We would do a couple of tests,

 

To the hospital he sent me

Though I didn’t feel that bad,

He arranged for them to give me

Every test that could be had.

 

I was fluoroscoped and cystoscoped,

My aging frame displayed.

Stripped, on an ice cold table,

While my gizzards were x-rayed.

 

I was checked for worms and parasites

For fungus and the crud,

While they pierced me with long needles

Taking samples of my blood.

 

Doctors came to check me over,

Probed and pushed and poked around,

And to make sure I was living

They then wired me for sound.

 

They have finally concluded,

Their results have filled a page,

What I have will someday kill me;

My affliction is OLD AGE!!

 

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Reprinted from the Hawaii Post-Polio Network, July/August 2004  newsletter.  This, too, has been e-mailed over – Thank you Jane.

 

MEDICARE

 

Medicare is an essential health care program for people 65 and older, people with certain disabilities, and people with End-Stage Renal Disease.

 
Medicare is divided into two parts: Part A - Hospital Insurance and: Part B - Medical Insurance. If you worked for 10 years or more and paid into the Medicare System through your paychecks, Part A is at no cost to you. Part B is an optional service that (at present) you can pick up at $ 66.60 per month, which comes right out of your Social Security check. If you don't pick it up when you become eligible for it there is a 10 % penalty per year for each year that you don't pick it up and there is no cap on that.

 

Medicare does not cover everything. There are a lot of gaps, co-payments, deductibles as well as limitations. For example you have only 60 lifetime reserve days to stay in hospitals above the 90 day benefit.

 

One of the advantages of being on Medicare is that Medicare puts caps on certain services. For example if you go to a doctor the doctor can charge you anything they want. If someone who has Medicare goes to a doctor, they have a cap on how much they can actually be charged for a particular service.


Durable Medical Equipment

One of the items covered under Medicare Part B is Durable Medical Equipment such as wheelchairs, walkers, canes, crutches, prosthetics, orthotics, etc. They typically require a "Certificate of Medical Necessity." It has to be medically necessary and has to meet the Medicare guidelines. It has to be for appropriate use in the home, intended for sick or injured and it has to be prescribed by a physician.


Unfortunately there are no caps on Durable Medical Equipment. Durable Medical Equipment companies can charge whatever the community is willing to pay (or not willing to pay). They can make their own prices. If one goes to a company to buy a wheelchair and the company says the chair is $500. Medicare may say we feel its value is $100. This means that one will have to pay $400 out of one's own pocket. There are suppliers, which participate and accept assignments with Medicare. This means they are willing to accept whatever Medicare will pay for the person buying the equipment. Those groups change continuously. They are on the "medicare.com" website or you can call us in case you need a wheelchair or walker. We can give you a company in your area that participates in accepting assignments. One of the companies that falls into this category is "Hawaiian Island Medical Corp." in Kakaako. You will pay your 20% but no excess above that. This can save you on your out of pocket expenses. Medicare also covers certain items needed by patients who have diabetes and eye problems, but generally Medicare will not cover anything for use in the bathroom.

 

SUPPLEMENTAL POLICIES

Supplemental Policies are sold by private companies. In Hawaii, people with Medicare have 3 options to purchase additional coverage:

 
Medigap
Medigap Plans benefits are standardized by the Federal Government. There are 10 plans to choose from. The plans range from "basic and least expensive" to "comprehensive and most expensive." These plans are very good for "snow birds". People who live in
Alaska for 6 months and in Hawaii for 6 months. The plan travels with them.

 
Medicare + Choice

"Kaiser Senior Advantage" is the only Medicare + Choice plan available in Hawaii. Services must be received from the plan's network of providers. There is little or no paperwork and nominal out of pocket expenses.


Competitive Medical Plan

The only provider in Hawaii of this plan is HMSA. The plan is called: "HMSA 65C+". Members are required to be enrolled in Medicare Part B. As with the Kaiser Plan services must use the network providers, there is little or no paperwork and nominal out of pocket expenses.

FECPPSG Editor’s Note:-  Although this comes from the Hawaii Post-Polio Support Group’s newsletter, I feel that every state has their own Medicare Supplemental plan in one way or another.

 

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Reprinted from the Triad Post Polio Spt Grp’s Seagull newsletter, June 2004, with the permission of Dr. Holland who e-mailed to tell me he did this particular article, he thinks, in 2000. 

NORMALCY

                                                                                                            By Dr. Henry Holland

 


 

In trying to understand something about the psychological effects of polio,  we have often heard how most polio victims exercised and worked vigorously to regain a sense of being normal.  In a general sense,  this usually meant trying to achieve a level of physical function and social function that was nearly equal to the pre-polio level of function and achieve-ment.  Many times this goal was unreachable in measurable physical function.  For example, President Franklin Roosevelt firmly believed that he would walk again after his initial polio attack.  He actively engaged in physical therapy for seven years trying to walk again.  He never walked again, but he did manage to walk for short distances with the assist-ance of two long leg braces, a cane, and a companion's arm.  A mystery does arise in attempting to explain the psychological impact that this tremendous effort made on the psyche and personalities of hosts of young polio victims.

 

          Being normal can include the simplest of tasks such as being able to feed oneself,  dress oneself,  and attend to one's own personal hygiene as well as strenuous tasks such as running fast, climbing stairs, and peddling a bicycle.  This is all relative to the degree of disability because the simplest of tasks can easily become the most strenuous of tasks.  For example when I had polio at age eleven, one of the most strenuous, challenging and frustrating goals that I encountered was trying to learn how to get off the floor or ground without the assistance of another individual.  I attempted this in physical therapy sessions at MCV with the use of two long leg braces and two crutches.  Success depended on upper body strength, good balance, determination , and overcoming the fear and reality of falling.  In time I was successful.  Now , with post-polio, I cannot get off the floor or ground without assistance.  Also, currently, I do not expect to overcome this limitation.  Psycholog-ically,  this loss of a previous level of function can make one feel less than normal, and more dependent.

 

          For many of us, being normal included achieving a good education, getting married, having children, and pursuing a career if possible.  Of course,  these "normal" goals were common among everyone in the 1940's and 1950's.  Obviously, these goals were extremely difficult for many polios because of an inner sense of being "crippled", different, or "handicapped".  However, recent polio surveys bear out that as a group in the populous,  polios have achieved more education, married at a higher percentage, and have had higher  employment per-centages than other disabled groups or even in comparison to the non-disabled.  Now, after several decades, what toll has "being normal" had on our personhood or sense of self?

 

          Trying to be normal has probably made us into overachievers.  I am sure this is nothing new to most of you.  In addition,  I believe it has also helped us to develop a greater sense of empathy for others in adversity, has made us more tolerant,  and has probably made us more stoical.  In blunt terms, to change is most difficult for us.  Paradoxically,  maybe we shouldn't change.  Maybe, we should continue to  be "normal".  I think we have gotten good at it.  We just need to alter our ways.  Our support group has certainly helped me and others in making healthy


 

adjustments.  Five years ago, I acquired an electric scooter.  Guess what?  I save immense energy.  Last year, my son built a sturdy ramp for our house.  Guess what?  I save more energy.  Also, in a practical sense, I attempt to do more brain work and less physically demanding work.  This also saves energy.  So at least intellectually.  I still feel normal.

 

          Perhaps at future meetings, some of us can be spotlighted to share experiences in trying to be normal.  I think we would be enlightened and feel a sense of individual and collective validation.  Maybe, over the many years, the toll on our psyches and personalities has not been injurious.  Perhaps, conversely, the toll of being normal has resulted in character integrity, wisdom, and love.  Everyone should feel good about this kind of normalcy.  To borrow an idea from Forrest Gump, maybe “normal is as normal does”.

FECPPSG Editor’s Note:-  This article brought back so many memories….  I always thought I was “normal”, don’t know why others thought I was “different”…

 

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Reprinted from Polio Heroes of TN, June 2004

 

SWALLOWING and GERD

 

By Steven Martin, MD, Gastroenterologist and member of the faculty of the University of Cincinnati Med. Center.

Originally reported by Henry Meek, Polio Connections, Cincinnati, Ohio – 2003

 

          When the polio virus attacked the bulbar area of the upper spinal cord, it also affected the brain stem, including the vagus nerve, according to Dr. Steven Martin.  The vagus nerve controls the voluntary (striated) muscles of the larynx and pharynx, as well as the involuntary (nonstriated) muscles of the esophagus, stomach, and trachea.  This is a common involvement in Bulbar polio, and occurred in 20% of acute polio cases.  The term bulbar polio is descriptive of the area of the spinal cord that was affected.

         

Since the polio virus directly affected nerves to striated muscles, the upper one third of the esophagus may be weakened.  Diaphragm weakness may also occur in polio survivors even in the absence of any bulbar involvement.  Dr. Marin cited a 1999 study, which found that about half of the polio survivors in the study were aware of dysphagia (swallowing problems) and that a significant number had an abnormal swallow.  As this delayed esophageal motility may be progressive, he encouraged polio survivors to consult a speech/language pathologist if there is any problem, and to initiate remedial strategies to avoid the consequences of dysphagia.

 

                Gastroesophageal reflux is both normal physiologic phenomenon and a pathophysiologic phenomenon (gastrin-testinal reflux disease or GERD) that can result in mild to severe symptoms.  Thirty six percent of the population has a problem greater than once a month, with 7% having a daily problem.  Stomach fluids are very acidic and have a pH of 1.  The esophagus is designed for a neutral pH of 7.  Saliva is neutral and is continually flushing the esophagus to protect.

 

          Heartburn is a burning sensation or discomfort behind the breastbone and is the most common symptom of GERD.  Other symptoms include bloating, nausea, vomiting, persistent cough, and bad breath.  Polio survivors should be aware that, since the stomach is controlled by the vagus nerve, they may be at greater risk.

 

          Complications of GERD include esophageal erosion, ulcer, and pulmonary aspiration.  Factors that may exacerbate the symptoms of GERD include smoking, caffeine, chocolate, fatty foods overeating with gastric distention, tight clothing, the presence of a hiatal hernia (which may be more prevalent in polio survivors), and certain medications.  While avoidance of exacerbation factors may be helpful, there is relatively little data supporting the efficacy of lifestyle modifications alone for the treatment of GERD.  For some patients, avoiding bedtime snacks and elevating the head of the bed are successful in relieving nighttime problems.  Dr. Martin reported that digestive disease affects over 40 million people in this country and that diarrhea is the third largest cause of death worldwide.

 

Dr. Martin’s principle patient goals are to relieve the symptoms, allow healing, and prevent scarring of the esophagus.  Drug therapy consists of antacid buffers, H2 blockers and Zantac and Pepcid that block one of the three arms that generate acid, and proton pump inhibitors such as Nexium and Prevacid that block all acid production.  Dr. Martin warned that, while certain ulcers are caused by bacteria, others are caused by medicines such as aspirin.

         

Some patients may have problems with complete stomach emptying.  There is medication as well as surgery that can be used for this condition.  This problem usually starts after age 50 and should be diagnosed.  Since polio survivors may have vagus nerve involvement, this condition may be more prevalent.

 

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Reprinted from Post-Polio Health (formerly called Polio Network News) with permission of Post-Polio Health International (www.post-polio.org). Volume 20, No. 2, Spring 2004. Any further reproduction must have permission from copyright holder.

 

EXCERPTS FROM

S.O.S. Save Our Shoulders:

A Guide for Polio Survivors

Jennifer Kuehl, MPT, Roberta Costello, MSN, RN, and Janet Wechsler, PT; Moss Rehabilitation Research Institute, Philadelphia, PA

 

          Many polio survivors report new symptoms as they age.  Some of the more common symptoms include loss of strength, fatigue, muscle twitching, cramping, and muscle or joint pain.  These symptoms, combined with muscle weakness caused by the poliovirus, often lead to problems with activities like climbing stairs or getting up from a chair or sofa.

 

          When muscle weakness and/or pain is present in one area of the body, people often compensate by putting more stress on another area of the body.  For example, polio survivors who have weak leg muscles often rely on their arms to assist with mobility-related tasks such as pushing off of the armrests of a chair when getting up or pulling upon the railing when going up a flight of stairs.  This behavior can increase the risk for symptoms of shoulder overuse.  These symptoms can include pain, swelling, weakness, and loss of motion of function in one or both shoulders.

 

Facts about Shoulder Problems